Dissociative identity disorder and the nurse-patient relationship in the acute care setting: an action research study.

This paper presents the results of an action research study into the acute care experience of Dissociative Identity Disorder. The study, which was grounded in principles of critical social science, utilized focus group interviews and narrative construction. Nurses and patients are under-represented in all clinical evaluation and their voices need to be heard if services are to be truly collaborative. Findings of the study extend intrapsychic theories of trauma to emphasize the interpersonal relationship between nurse and person who can work together to facilitate recovery from trauma, make connections both intra and interpersonally and build resilience.

Osteonecrosis following treatment for Hodgkin's disease.

Osteonecrosis is usually considered to be a minor and rare late sequelae of treatment for Hodgkin's Disease (HD). However, over ten years six patients out of a total of 53 patients treated for HD at the haematology department of a district general hospital developed osteonecrosis, an incidence of 11.3%. Routine isotope bone scanning of patients produced two further asymptomatic cases. These results suggest a higher incidence than previously suspected of a problem which caused our patients considerable morbidity. Further measures are required to identify and adequately treat a significant cause of late morbidity following chemotherapy for HD.

Some factors affecting the release of imipramine from gel-precipitated aluminium hydroxide spheres.

Changing the pH of the dissolution medium has been found to affect the release of imipramine from gel-precipitated aluminium hydroxide spheres. Release from unwashed, unheated spheres into solutions of pH 1.2 was controlled by dissolution of the gel matrix, whereas that into solutions of pH 3 and pH 5 appeared to be under diffusion control. The liberation of drug from unwashed, heated spheres into the media of higher pH exhibited more complex kinetics. Washed spheres failed to release significant amounts of imipramine into the solutions of pH 3 and 5. Changing the ionic strength of the media had little effect on drug release. These phenomena have been explained with reference to model theories of the precipitation and ageing of aluminum hydroxide gels and their pH-solubility profiles.

The production and properties of gel precipitated aluminium hydroxide spheres containing imipramine.

The production of aluminium hydroxide spheres containing imipramine by gel precipitation of liquid feed solutions has been described. Washing and heating procedures applied to the precipitated spheres markedly affected the rate of drug release from the spheres into 0.1M hydrochloric acid. Increasing the imipramine content of the spheres also altered the drug release rate. The effects described have been explained with reference to model theories of the precipitation and ageing of aluminium hydroxide gels in the presence and absence of 'foreign' anions.

Bone and joint tuberculosis in Glasgow: the present situation.

A retrospective survey of bone and joint tuberculosis in the City of Glasgow over the decade 1966-75 has been carried out. Its object is to chart the changing pattern of clinical presentation of this disease, and details of 129 patients are presented. The numbers of children and adolescents are relatively low: Asian immigrants and the elderly are now the higher risk groups. A positive culture was obtained from 60 per cent of the bone and joint lesions and in every case the organism was human Mycobacterium tuberculosis. Tuberculosis complicating a closed fracture is a very rare occurrence; this series includes one further such case. Delay in diagnosis was evident in a significant number (11%) of patients. We must bear in mind the fact that we still have with us not only the great Victorian architecture, but also the great Victorian disease.

Temporary arterial shunt in the severely injured limb.

Silicone rubber tubing and matching vessel tips are available in any hospital with a renal dialysis unit. These materials may be used as a temporary measure to restore distal circulation in the severely injured limb. The operative technique and postoperative management of a case in which this manoeuvre was used are presented.